Good afternoon and welcome to my regular patient safety update. The Health and Care Bill is the main news this week but we also look at ambulances, medical device biases, and coronavirus. As ever, you can sign up to receive this update via our website here and please tell any friends you think might enjoy it.

HEALTH AND CARE BILL I generally try to be positive in these emails as there is important progress being made in many areas. But yesterday was unmistakably a bad day when the government decided to vote down my NHS workforce Amendment 10 to the new Health Bill for completely inexplicable reasons. The government majority was 61 but would have been just 15 if the SNP had supported it which initially they said they would, and despite heavy whipping 18 Conservatives supported it and 61 abstained which was encouraging. All it did was require the Secretary of State to publish independently verifiable workforce projections and training requirements every two years. Given the workforce crisis (including shortages in every specialty) is the No 1 issue in the NHS (and a major threat to patient safety), it is extraordinary that the government should whip against the single biggest thing that could help sort out the issue. During a largely good-natured debate yesterday, I argued not only that we owe this to frontline staff who are under huge pressure but also that it would actually save money for the NHS by reducing the locum bill. We had great support from 50 NHS Organisations, every Royal College, the BMA, Labour, SNP, and Liberal Democrats, as well as 6 Select Committee chairs and many Conservative colleagues and I now hope that it will be put into the Bill by the Lords - and that the government thinks again before voting it down a second time. You can also hear my explanation of the measure in this Today programme interview (0810 slot). 

OTHER AMENDMENTS TO THE BILL On the other hand, there was some good news on Monday when my Amendment 114 was accepted by the government. It basically paves the way for Ofsted-style inspections of the new Integrated Care Boards including on the quality and safety of care. I hope it means the ICBs are inspected in the same transparent way as are hospitals, GP surgeries and care homes. I argued it will align to regulatory environment and make sure the new boards are patient-facing. New clauses 21 and 22, which I also signed, were measures to prohibit virginity testing and hymenoplasty– two abhorrent practices – which the government has also accepted. The government also accepted a clause to include cancer outcome targets in the NHS mandate.

SOCIAL CARE AMENDMENT Three steps forward two steps back with the government’s social care amendment which gave us all a dilemma on Monday (I ended up abstaining). The new measures mean support for anyone whose assets fall below £100k, which is far better that the current £23k – but the cap is much less progressive than the original Dilnot plans. But the real issue in social care is not the cap but inadequate funding for local authorities and a workforce crisis (which the Health Foundation says somehow needs to expand by 55% before 2030.)

AMBULANCES I am hearing some very worrying reports of ambulance services declaring Critical Incidents and people having difficulty getting through on 999 calls. I asked the Secretary of State about similar reports last month and am waiting for some data but Emergency Care is clearly experiencing a pre-January January.

BIAS IN MEDICAL DEVICES Remember the advice to get a home oximeter if you got Covid? Well now it looks like they may not be as accurate for people from minority ethnic backgrounds, contributing to the much-discussed higher death rate, so it is good that the Department of Health and Social Care announced over the weekend an independent review into the issue. 

COVID LATEST Data seems to pointing in different directions: cases rose by 9% in the last 7 days but population data is showing a small improvement – 1 in 65 people vs 1 in 60 the week before. Hospital data looking better too with just under 6,000 patients admitted to hospital in the last seven days, a 10% decrease from the week before, and about 8,100 patients in hospital, slightly lower than the 9,000 last week. With further lockdown restrictions once again in Austria and other parts of Europe we are all now wondering if we will be OK or not here. Freedom Day in July may actually have helped boost natural immunity and alongside the biggest booster programme in Europe we do still appear to have a good chance of a normal Christmas – there I needed to cheer myself up after yesterday’s infuriating vote…

Jeremy Hunt